| NPI | 1689680092 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: CA A068701) |
| Additional Taxonomies | 208M00000X Hospitalist (Licence: CA A068701) |
| 207RH0002X Internal Medicine, Hospice and Palliative Medicine (Licence: CA A068701) | |
| Enumeration Date | 2006-07-31 |
| Last Update Date | 2016-05-25 |